A Case of Infertility from Premature Menopause

Drs. Prajakta Vaidya and Preety Shah-Chauhan present a case of infertility due to premature menopause.

A 32 year old female came to us on 21-Feb-13 with the chief complaint of premature menopause leading to infertility. She started having irregular menses followed by amenorrhea over the last 6 months. She is a mother of a 4.5 yr old boy and has medically terminated two pregnancies in the past. She wishes to conceive again since the last year. Her treating Gynaecologist had suggested trying in-vitro fertilization (IVF) immediately, as she would attain menopause within 6 months.

Along with the chief complaint, she also suffered from:

Frequent Upper Respiratory Tract Infection (URTI)

Frequent headaches

Inadequate sleep

A detailed homeopathic consultation was done which involved an in-depth history taking of patient’s presenting complaints, including her mental and physical constitution.

Case History:

When she was informed about her early menopause and IVF it was a sudden shock for her. She had aborted in the past because she and her husband were not financially settled to have another child. Now she feels guilty. (Weeps) “I was always a single child. I used to feel bad; I did not have any sibling to share my feelings in childhood. I would like a big family but now periods are delayed and I have to go for either IVF or menopause. That is really worrying me. I will not have a big family. My child will not have anyone to share his feelings ‘’

“I feel very guilty because I took the decision of abortion. I feel life is ended here. Nothing can be done for this. I feel incomplete. I feel I am worthless. Even my husband wanted a second baby but I cannot help it now. I am the reason for it. Life has just started for me but now I am stuck”

She says “I follow all the instructions given by my doctor, I have taken all medicines given by them, I have “Andh vishwas” (blind faith) on them.”

She has tremendous anxiety about health and fears dreadful diseases. She says “I am scared whether I am having other diseases like renal failure, breast cancer, lung failure“. She is sensitive, doesn’t like to hurt people and is very sympathetic. She narrates “I cry easily whether I am happy or sad. I will cry even If I go to temple, if I see a child begging, if I get angry. I am very emotional. I cannot understand what I feel. Then repent after crying”.

When asked what does family mean to her? She says family means-support, security, with whom you can share, who gives moral support, company, who are there for you

Her parents are divorced and she is enormously affected by that. She was raised by her mother and always felt alone as a child. She does not like to be alone and she fantasizes about having siblings. She likes talking and sharing things. She feels very responsible towards her family and says time and again “I have to fulfil their needs, I want to keep them happy.” If her mother is not well, she feels very anxious “Dar lagta hai, main anath ho jayungi” (fears she will become an orphan).

She works as a private nurse. She wanted to become a police officer or a doctor and have a respectable job. She chose to be a nurse so that people would now call her “sister”. It sounds respectful.

Physical Generals:

She craves for Salty and Spicy food and is not fond of sweets. She feels thirsty, is occasionally constipated.

Observation:

The patient seemed to be extremely dependent on the physician. She kept saying “Doctor this medicine will help me for sure right? Is it okay if I call you in case of any doubts? I hope you will pick up my call? I will follow all your instructions.” It was a child like dependence. Childish way of talking

Case Analysis:

The central theme of the case was revolving around the issue of lack of support, feeling incomplete, dependency, responsibility. These issues indicate the Mineral Kingdom. The patient’s issues belong to Row 4, considering her insecurities related to financial and health issues. The extreme insecurity and anxiety and her complete dependence on family and desire for child confirm Row 4, Column 1

Repertorisation:

Fear-death of

Fear of being alone

Anxiety-health; about-own health

Anxiety-health, about-relatives; of

Weeping while narrating her complaints, causeless.

Menses Absent

Menses too late, too scanty.

Throat pain with burning < cold things.

Pain in breast before menses.

The patient was prescribed Kali carbonicum 200 and was off Hormone Replacement Therapy (HRT) immediately.

Table 1.0 shows her hormonal panel done between Nov-12 and Dec-13. Her homeopathic treatment was started on 21-Feb-13.

Test

When→

What ↓

09-11-12

06-02-13

21-05-13

03-07-13

18-12-13

LMP

Not Available

19-12-13

(with HRT)

2-05-13

2-05-13

19-10-13

FSH

16.47

7.25

2.73

3.3

LH

10.27

2.98

2.46

14.09

Prolactin

9.78

39.52

16.63

11.91

Testosterone

27.56

22.61

Anti-Mullerian Hormone (AMH)

<0.30

<0.30

Table1.0 Hormone Panel

Follow-ups:

The patient started natural menses immediately on day 2 after her first dose of Kali Carbonicum 200. Her menstrual cycle slowly started becoming regular with occasional missed cycles. Other associated complaints during menses like cramps, heaviness in the breast etc became better. Her hormone panel was repeated as shown in Table 1.0 above.

Her episodes of URTI and headaches reduced considerably and their intensity also reduced. MRI Brain was done in consultation with a physician in May’13 which showed small arachnoid cyst- 3.2X 1.1 cm in left anterior temporal convexity. She received the same constitutional homeopathic remedy for this as well.

Her Urine Pregnancy and USG confirmed pregnancy on Aug’13. However, she started bleeding spontaneously and the pregnancy could not be retained.

Her Urine Pregnancy Test was positive again in Feb’15. Below are the sonography results:

USG on 28-Apr-15 shows-Single intrauterine viable foetus with gestational age of 16 weeks and 5 days.

Quadruple Test in May’15 showed Trisomy-21 as 1:250, Trisomy-18 as 1:100 and & AFP MoM above 2.5. No further confirmatory tests were done.

She delivered a healthy baby girl on 10-10-15 weighing 2.9 kgs.

The graph below demonstrates patient’s menstrual cycle and key milestones during her treatment.

Graph 1.0: Menstrual cycle and key milestones

Conclusion:

Over the course of 2 years patient was given Kali carbonicum intermittently and the potency was increased up to 10M. Based on her mental and physical state Arsenic album 10 M was prescribed (after stopping Kali carbonicum) in Feb’14. She has received infrequent doses of Arsenic album 50M till date.

Patient’s husband was also treated with homeopathy for his Gastric complaints and infertility.

She was on homeopathy for overall wellbeing along with the routine Gynaecology care during her pregnancy.

About the author

Dr. Prajakta & Dr. Preety

Dr. Prajakta Vaidya, MD and Dr. Preety Shah-Chauhan, BHMS operate Healing Harmony, which is a homeopathic holistic healing initiative. Their approach is multi-dimensional and they offer a range of holistic therapies along with homeopathic treatment. Dr. Vaidya and Dr. Preety Shah-Chauhan are a dynamic duo with over 8 years of practice together. They are both staunch believers in the “wholistic” concept of health and tactfully interweave the science and art of homeopathy with diet, yoga, meditation, counselling.